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Surgical treatment of ingrown toenails
Surgical treatments of ingrown toenails include a number of different options. If conservative treatment of a minor ingrown toenail does not succeed or if the ingrown toenail is severe, surgical management is recommended by a podiatrist. The initial surgical approach is typically a partial avulsion of the lateral nail plate known as a wedge resection or a complete removal of the toenail.〔 If the ingrown toenail reoccurs despite this treatment, destruction of the germinal matrix with phenol is recommended.〔 Antibiotics are not needed if surgery is performed.
== Wedge resection ==
Partial removal of the nail or an offending piece of nail. Here, the digit is first injected with a common local anesthetic. When the area is numb, the physician will perform an onychectomy in which the nail along the edge that is growing into the skin is cut away (ablated) and the offending piece of nail is pulled out. Any infection is surgically drained. This process is referred to as a "wedge resection" or simple surgical ablation and is non-permanent (i.e., the nail will re-grow from the matrix). The entire procedure may be performed in a physician's office and takes approximately thirty to forty-five minutes depending on the extent of the problem. The patient is allowed to go home immediately and the recovery time is anywhere from a two weeks to two months barring any complications such as infection. As a follow-up, a physician may prescribe an oral or topical antibiotic or a special soak to be used for approximately a week after the surgery. Some use "lateral onychoplasty" or "wedge resection" as the method of choice, for ingrown toenails. A wide wedge resection, with a total cleaning of nail matrix, has a nearly 100% success rate.〔Harry Gouvas: Wedge Resection (Lateral Onychoplasty) as the method of choice for Ingrown Toenail". Orthopaedic Medical Congress in Athens, 14 Oct, 2004, paper, 148〕 Some physicians will not perform a complete nail avulsion (removal) except under the most extreme circumstances. In most cases, these physicians will remove both sides of a toenail (even if one side is not currently ingrown) and coat the nail matrix on both of those sides with a chemical or acid (usually phenol) to prevent re-growth. This leaves the majority of the nail intact, but ensures that the problem of ingrowth will not re-occur. There are possible disadvantages if the nail matrix is not coated with the applicable chemical or acid (phenol) and is allowed to re-grow; this method is prone to failure. Also, the underlying condition can still become symptomatic as the nail grows out over the course of up to a year: the nail matrix might be manufacturing a nail that is simply too curved, thick, wide or otherwise irregular to allow for normal growth. Furthermore, the flesh can be injured very easily by concussion, tight socks, quick twisting motions while walking or just the fact the nail is growing wrongly (likely too wide). This hypersensitivity to continued injury can mean chronic ingrowth; the solution is nearly always edge avulsion by the highly successful phenolisation.
抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』
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